Physical and hormonal evaluation of transsexual patients: A longitudinal study

Abstract

The physical and hormonal characteristics of 60 male-to-female transsexuals and 30 female-to-male transsexuals were measured before or during treatment with commonly used forms and dosages of hormones. Only two patients (both female-to-male) had either a congenital defect in hormonal production or abnormal genital development. Patients were seen at 3- to 6-month intervals for an average of 18 months. The response to therapy was examined over time; physical parameters, hormonal concentrations, liver function tests, lipids, and glucose were measured. Three patients were changed from ethinyl estradiol to conjugated estrogen because of liver enzyme elevations. Ethinyl estradiol (0.1-0.5 mg/day) was equal to conjugated estrogen (7.5-10 mg/day) in its ability to suppress testosterone and gonadotropins and to promote breast growth. Maximum breast growth required 2 years of therapy. During treatment with testosterone, female-to-male transsexuals had a significant mild elevation of cholesterol and triglyceride. The female-to-male transsexuals receiving testosterone cypionate, 200 mg every 2 weeks, ceased to have menstrual periods and became progressively masculinized. A mean maximal clitoral length of 4.6 cm which achieved by 1 year of therapy. Based on the data generated by this study, we recommend as hormonal therapy 0.1-0.5 mg/day of ethinyl estradiol or 7.5-10 mg/day of conjugated estrogen for male-to-female transsexuals, and intramuscular testosterone cypionate, 200 mg every 2 weeks, for female-to-male transsexuals.

Cross-Sex Hormone Treatment and Psychobiological Changes in Transsexual Persons: Two-Year Follow-Up Data

“…Finally, in FtMs the clitoris starts to increase by 60% after only 3 months from starting T treatment and continues to grow, almost doubling after 2 years, at variance with the aforementioned study (38), demonstrating a plateau after 1 year.…”

A review of the physical and metabolic effects of cross-sex hormonal therapy in the treatment of gender dysphoria

“…7 Breast development begins in about two to three months after the initiation of treatment and the maximum effect of oestrogen on breast development is not seen until two years of oestrogen therapy. 8 The average breast development is 14.5 AE 1.2 cm; this equates to a B cup brassier size.…”

Effects of transdermal testosterone or oral dydrogesterone on hypoactive sexual desire disorder in transsexual women: results of a pilot study

“…Transsexuals often believe that treatment with progestins has positive effects on breast growth and libido, but to our knowledge there has been no scientific proof of this assumption. The use of progestin as part of the endocrine treatment regimen for male-to-female transsexuals is a matter of controversy, and a clinical effect of progestins has not been evident in small observational studies (38). However, advantages have been observed in some patients with abnormal psychological irritability and mammary tenderness (39).…”